Abstract:
INTRODUCTION:An international multicenter randomized trial comparing standard pressure differential valves, Orbis Sigma valves and PS Medical Delta valves, for children with newly diagnosed hydrocephalus failed to show a difference in the time to first shunt failure (power 80%). In order to avoid observer bias, the primary endpoint, shunt failure, was defined by detailed clinical and radiological criteria. Surgeons notified the data center when their patient reached endpoint. Their decision was blindly reviewed by a centralized adjudication process. The current analysis asks: (1) Did the surgeons and the blinded adjudication process agree on the presence of shunt failure? (2) Do the shunt survival curves change when the surgeons' assessment of outcome is used? METHODS:The two methods of outcome assessment (surgeons' decision and adjudication process) were compared with a kappa statistic for the presence of shunt failure and a log rank statistic for time to shunt failure. RESULTS:The surgeon and the adjudication process agreed on the presence of the primary outcome in 313/344 patients in the trial (kappa = 0.81). The 31 cases of disagreement were evenly distributed among the three shunts. The survival curves generated from the surgeons' decision were not significantly different from those generated by the adjudication process (log rank = 0.70, p = 0.37) and did not alter the study conclusions. DISCUSSION:Observer bias in the assessment of outcome is always a concern in an unblinded clinical trial such as this one. We did not detect an observer bias of sufficient magnitude to alter the study conclusions.
journal_name
Pediatr Neurosurgjournal_title
Pediatric neurosurgeryauthors
Kestle J,Milner R,Drake Ddoi
10.1159/000028764keywords:
subject
Has Abstractpub_date
1999-02-01 00:00:00pages
57-61issue
2eissn
1016-2291issn
1423-0305pii
28764journal_volume
30pub_type
临床试验,杂志文章,随机对照试验abstract:PURPOSE:Craniosynostosis patients treated with one-stage cranioplasty often have bleeding from the dura mater, fluid collection in the extradural space, and poor wound healing due to skin overstretching. To avoid these complications, we began using distraction osteogenesis. To determine the advantages and disadvantages...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000094064
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE/AIM:Hydrocephalus is defined as an incapacitating neurological disorder characterized by ventricular enlargement in children, but the effects of melatonin on this hydrocephalus have not yet been fully elucidated. In the present experiment, we attempted to investigate the effects of exogenous melatonin adminis...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000488497
更新日期:2018-01-01 00:00:00
abstract::Extraventricular neurocytomas mimic central neurocytomas histologically but are located outside the lateral and/or third ventricles. Pontine neurocytomas represent an extremely rare subset of extraventricular neurocytomas, and reports are limited to 2 adults followed under 28 months. The authors present the case of a ...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000351576
更新日期:2012-01-01 00:00:00
abstract::The Meckel-Gruber syndrome is a rare, congenital, and lethal malformation characterized by typical manifestations such as encephalocele, polycystic kidneys, and polydactyly. Herein, we present a case of a patient with the typical triad as well as facial, ocular, liver, and genital abnormalities who lived for almost 5 ...
journal_title:Pediatric neurosurgery
pub_type:
doi:10.1159/000500766
更新日期:2019-01-01 00:00:00
abstract::Although extra-axial hematomas are a well-known complication of ventricular shunting, epidural hematomas are uncommon in this setting. We report an unusual case of multiple epidural hematomas in a patient with hydrocephalus treated by ventriculoperitoneal shunt. The patient became symptomatic 5 days after shunting and...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000120704
更新日期:1993-03-01 00:00:00
abstract::Inflicted traumatic brain injury (TBI) is a frequent consequence of physical child abuse in infants and children. Twenty-eight children who were 2-42 months of age when hospitalized for moderate to severe TBI were enrolled in a prospective, longitudinal study of neurobehavioral outcome following acquired brain injury....
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000028872
更新日期:1999-11-01 00:00:00
abstract::Osteoblastomas and aneurysmal bone cysts are uncommon benign tumors of the spine. Their presentation can vary between diffuse pain, restriction of neck movements, torticollis, radiculopathy, and myelopathy. Complete excision is the best treatment to achieve a cure, but recurrence is not uncommon. A combination of the ...
journal_title:Pediatric neurosurgery
pub_type:
doi:10.1159/000495065
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Spinal cord injury (SCI) is a leading cause of morbidity and mortality among youth and adults. Secondary injury mechanisms within the spinal cord (SC) are well known to cause deterioration after an acute impact. Free radical scavengers are among the most studied agents in animal models of SCI. Edaravone is a...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000335400
更新日期:2011-01-01 00:00:00
abstract::Fetus in fetu (FIF) is an extremely rare congenital anomaly in the pediatric age group. It is defined by the presence of an axial skeleton and well-formed internal organs in a fetiform mass. Only about 15 cases of intracranial FIF have been reported in the literature worldwide. We report a case of temporo-occipitocerv...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000441035
更新日期:2016-01-01 00:00:00
abstract::Cystoperitoneal (CP) shunting is minimally invasive and achieves a high rate of resolution on neuroimaging. However, in the absence of definite symptoms, shunting should be reconsidered, because some patients can experience shunt dependency after CP shunting. In this study, the risk of shunt dependency in patients wit...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000065393
更新日期:2002-10-01 00:00:00
abstract::Although the transsphenoidal approach offers a narrow operative field and poor visual control through a small sellar opening, this approach has the advantage of being associated with minimal surgical trauma, especially in children. We share our experience of good surgical outcome achieved by the transsphenoidal approa...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000071321
更新日期:2003-07-01 00:00:00
abstract::Most cerebrospinal fluid (CSF) shunts employed in the treatment of hydrocephalus include in their designs a pump mechanism that has been used in office practice as an indicator of whether the shunt is functioning properly; however, the pumping characteristics of shunts have been shown to correlate poorly with clinical...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000121100
更新日期:1996-08-01 00:00:00
abstract::Surgical pathology of the pediatric cranial base is uncommon, but in affected children, traditional operative techniques and management philosophies predominate. While the creation of multidisciplinary skull base teams synergistically pools the talents of individual specialties, a better understanding of the developme...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000067558
更新日期:2003-01-01 00:00:00
abstract::Hydrocephalic (n = 19) and normal (n = 20) children in two age groups (averaged at 10 and 14 years old) were asked to learn 5 predetermined timing rhythm interval tasks (including timing duration and relative timing pattern) by pressing keys on a computer keyboard. In the acquisition phase, visual and auditory goal ti...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000056017
更新日期:2001-04-01 00:00:00
abstract::A case of a 16-year-old male with both a nasal dermoid sinus cyst (NDSC) and a third ventricle colloid cyst is presented. The NDSC was excised via a single-stage combined intracranial-extracranial approach and the third ventricle colloid cyst was resected endoscopically. The pathogenetic theories of NDSC and third ven...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000028862
更新日期:1999-10-01 00:00:00
abstract::This study was performed to compare the effects of continuous intrathecal baclofen infusion (CIBI) and selective posterior rhizotomy (SPR) on upper extremity (UE) spasticity and range of motion in children with cerebral palsy. Spasticity was assessed with the Ashworth scale of muscle tone and range of motion was evalu...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000120941
更新日期:1995-01-01 00:00:00
abstract::Thirty-six cases of pilocytic astrocytomas treated at the Childrens Hospital of Los Angeles from 1984 through 1995 were reviewed. The mean age at initial presentation was 8 years (range 15 months to 14 years). These patients were followed for an average of 5.5 years. No patient was given chemotherapy or radiation ther...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000121218
更新日期:1997-07-01 00:00:00
abstract:INTRODUCTION:Nondysraphic intramedullary lipomas of the spinal cord are rare lesions. They are most commonly seen in the second or third decade of life. Their occurrence in the pediatric age group is even rarer. CASE REPORT:The authors describe a 14-month-old child who presented with delayed motor milestones involving...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000334258
更新日期:2011-01-01 00:00:00
abstract::Craniopharyngiomas can be divided into sellar, prechiasmatic, retrochiasmatic and giant tumors. The initial approach to a craniopharyngioma should be an attempt at its removal. Only if surgical therapy fails to deal with the tumor should more conservative approaches utilizing radiotherapy be used. The use of intracyst...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000120861
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Growing skull fracture (GSF)/pseudomeningocele is a rare complication of head injury in children. Post-traumatic intradiploic arachnoid cyst (PTIAC) is a variant but it is extremely rare. PTIACs are usually asymptomatic or with mild symptoms like headache. The rupture of PTIAC due to re-trauma leading to pse...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000369936
更新日期:2015-01-01 00:00:00
abstract::We evaluated the prevalence of pathological visually evoked potentials (VEP) before the appearance of papilledema or other signs of elevated intracranial pressure in children suffering from craniosynostosis. In 52 children (19 girls, 33 boys, median age 7.6 months, mean age 7.6 months, range from 3 to 34 months) preop...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000028746
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND/AIMS:We sought to describe pediatric "big data" publications since 2000, their statistical output, and clinical implications. METHODS:We searched 4 major North American neurosurgical journals for articles utilizing non-neurosurgery-specific databases for clinical pediatric neurosurgery research. Articles we...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000495790
更新日期:2019-01-01 00:00:00
abstract::Several groups have begun to explore the feasibility and utility of intrauterine closure of myelomeningocele. A subset of these fetuses have defects which fall into the category of myeloschisis, and therefore have inadequate skin to enable primary closure. After considerable discussion, it was decided to utilize biped...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000028898
更新日期:2000-01-01 00:00:00
abstract:AIMS:We report a special type of skull fracture in children - internal open brain injury (IOBI). We summarize its clinical characteristics and propose a treatment strategy based on our experience. METHODS:Eight patients between 2 and 5 years old were identified to have IOBI. Preoperative computed tomography (CT) scann...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000260912
更新日期:2009-01-01 00:00:00
abstract::Holoprosencephaly is a rare congenital malformation resulting from an impaired midline division of the prosencephalon into distinct cerebral hemispheres. Hydrocephalus is a frequent problem among the few survivors with alobar holoprosencephaly (aHPE), its most severe form. The literature about neurosurgical management...
journal_title:Pediatric neurosurgery
pub_type:
doi:10.1159/000489856
更新日期:2018-01-01 00:00:00
abstract::A rare case involving multiple intracranial aneurysms with intraventricular hemorrhage (IVH) in a child, accompanied by unilateral fibromuscular dysplasia (FMD) of the renal artery, is reported. A 12-year-old girl presented with secondary hypertension and fourth-ventricle IVH. Cerebral angiography showed multiple aneu...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000180304
更新日期:2008-01-01 00:00:00
abstract::Hyponatremia is a common complication of intracranial disease or surgery. An evaluation should be undertaken to determine whether cerebral salt wasting (CSW) or inappropriate secretion of antidiuretic hormone is present as a cause. Since the treatment principles are completely different in the two pathological states,...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000050424
更新日期:2001-10-01 00:00:00
abstract::A case of an intracerebral juvenile xanthogranuloma (JXG) producing complex-partial seizures in a 13-year-old boy is presented. Although the child had no history of JXGs or a systemic histiocytic proliferative disorder, the histopathological and immunocytochemical studies of this lesion were identical to that of a cut...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000121212
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVE:Although subdural hematomas (SDH) are common in infants, their long-term outcome is poorly documented in the literature. METHODS:Infants operated for SDH were followed prospectively and evaluated during their sixth year with systematic neurological evaluation and standard neuropsychological testing. RESULTS...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章
doi:10.1159/000071648
更新日期:2003-09-01 00:00:00
abstract::Malignant tumors arising within dysrhaphic malformations are very rare and are mostly teratomas; so far, only one rhabdomyosarcoma has been reported in this context. We report another case of a girl with lipomyelomeningocele who developed a lumbar rhabdomyosarcoma 2 years after birth and primary closure of the neural ...
journal_title:Pediatric neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000083742
更新日期:2004-11-01 00:00:00